Depression: Not Caused By Serotonin?

Interesting debate piece in WDDTY this morning on the causes of depression.

In essence, the debate is that some experts don’t agree with the current thinking that depression is caused by a chemical imbalance, most commonly thought to be a lack of serotonin hence the zillions of us on SSRIs.

Depression: An Inflammatory Disorder?

Some believe it is essentially an inflammatory disorder and the article points to several studies that suggest they could have a point. I particularly found it interesting that people suffering from depression can have a high CRP (C-reactive protein) score, a measure of general body inflammation, although researchers weren’t sure if the CRP caused the despression or was a result of it so more studies to be done there. Interesting though.

The article points out that people suffering depression are more likely to get diabetes and  heart disease, both inflammatory disorders. I’m not sure about that one – couldn’t it it be linked to comfort eating the wrong foods when you feel rubbish too? Might be simplistic but perfectly possible.

You can easily check your inflammation level with the CRP or ESR scores via your GP. I can do a simple CRP check too if need be (just ask – about £50, I haven’t had a chance to list it yet on the shop), or here is the basic inflammation test and a more comprehensive one in case that is of use. They are not cheap, granted, but they are extremely useful.

Further down in the piece, there was a really useful checklist of other non-inflammatory, non-chemical causes of depression. These might be worth having a look at if you or anyone you know suffers with depression.

A Lesson in Food Allergy and Depression    

In clinic, I most often see it as a result of allergy/intolerance  – although no-one ever believes me until they feel better with the culprits removed. I remember my first ever patient was someone suffering with depression who had been in and out of hospital and on/off drugs all her life. As per protocol, I refused to treat her for her depression as I deemed it severe, but I did give a standard dietary prescription to remove the common allergens and control blood sugar.

Neither of us could believe the difference in her within 3 weeks. Now, not everyone has a reaction like that, of course, but it taught me a valuable lesson about food allergy and the effect on mood and mental state. I have never forgotten that so wheat and dairy, possibly gluten, are automatically removed whenever I see someone suffering from a mood disorder. Nine times out of ten it helps. Might not be the be-all-and-end-all of the case, but it’s unusual in my experience that it’s not part of it somewhere. In my view, allergy/food intolerance should be on this list too. For help coming off wheat and dairy, download the recipe book.

WDDTY Depression Causes List

• Household mould. Damp and mouldy environments appear to play a part in bringing on the condition—although researchers aren’t sure whether it is the mould itself, or being sick from the mould and feeling powerless to prevent it. Ed’s note: one way of checking mould in your house is to put a dish of sugary water with some cotton wool in it and leave in a room for a few days. If mould grows, there’s your answer!
• Hypothyroidism. One in five sufferers of chronic depression also has hypothyroidism, where the thyroid glands produce too little thyroxine, a hormone that helps to regulate heart rate, body temperature and the processing of food.   Ed’s note: the first test for hypothyroidism is the good old basal temperature, which picks up mild problems often missed by the blood test. See here. 
•      Reactive hypoglycaemia (low blood sugar). Diabetes is associated with depression, so it is not surprising that low blood sugar—brought about by eating sweet or starchy foods—is also linked. People who regularly eat fast food and/or processed baked products such as cakes and doughnuts are 51-per-cent more likely to develop depression (Public Health Nutr, 2011; 15: 424–32). Ed’s note: eat regularly every 2-3 hours, avoid white, sugary and chemical foods (eg. coke etc). Follow a low GL diet especially if you feel dizzy, shaky or irritable when missing meals. 
• Low vitamin D. This works both ways: people with high levels of vitamin D usually don’t get depressed, while those with low levels do. The vitamin may affect neurotransmitters, inflammatory markers and other factors that relate to depression. Ed’s note: check your Vitamin D levels and read more about the subject here. 
• Irritable bowel disease (IBD). Gastrointestinal problems are often the third side of a triangle that also includes anxiety and depression. About a third of people with Crohn’s disease also suffer from headaches, eye problems and depression. Ed’s note: most commonly caused by wheat or dairy intolerance in my experience. Read the gut plan. 
• Low testosterone. Older men with low levels of testosterone are more likely to have depression. In one study of 3987 men, those with the lowest levels were three times more likely to suffer depression compared with men who had the highest levels. Low hormone levels may be affecting neurotransmitters and other hormones in the brain (Arch Gen Psychiatry, 2008; 65: 283–9). Ed’s note: get this checked at your GP and/or do the male hormone saliva test. 
• Belly fat. There’s some connection between ‘central adiposity’—or belly fat—and depression. Researchers have found that people—and women in particular who were overweight or obese—with visceral fat around their middle are much more likely to suffer from depression. Ed’s note: see the reactive hypoglycaemia bit above – get the Belly Fat Low GL Plan
• Multiple sclerosis (MS). Up to half of MS sufferers also have depression that is unrelated to the psychological impact of the disease.
• Stroke. This is also closely associated with depression—and it could be because of the SSRI drugs. Up to half of all stroke victims become seriously depressed afterwards, although it is not always detected, and often mistaken as a late symptom of the actual stroke episode.
• Coeliac disease. Depression often accompanies coeliac disease, where eating wheat, rye, oats or barley damages the inner lining of the small intestine. Ed’s note: get a coeliac test before cutting wheat out, but be aware that tests are not 100% reliable. Read about coeliac and non-coeliac gluten sensivity testing here. 

You can read the whole piece here if you are a WDDTY member. Either way, have a look through that checklist. Easy to check most of them and could throw up some useful pointers that may go some way to relieving the problem, even if it might not solve all of it.

Hope that helps give you some alternative ways forward. For more on alternatives to SSRIs too, see here.